NPIMap

Individual provider Active NPI

Frederick A. Merrill III, D.O.

  • Family Medicine Physician
  • Evans, GA
National Provider Identifier
1740299650
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
034664 Issued in GA
Practice address
465 N Belair Rd
Suite 1C
Evans, GA 30809-3188
Phone
(706) 854-2160
Fax
(706) 854-2930
NPI assigned
Aug 7, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 034664 GA Primary

Addresses

Primary practice location

465 N Belair Rd
Suite 1C
Evans, GA 30809-3188

Mailing address

465 N Belair Rd
Suite 1C
Evans, GA 30809-3188
Phone (706) 854-2160

Other identifiers 1

IdentifierTypeStateIssuer
0473327GMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100125000597 GA Practitioner - Family Practice 9537118617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Physicians of EvansGroup PAC ID 9234028358, 9 clinicians

Practice addresses (Care Compare)

1321 Interstate Pkwy
Augusta, GA 30909-5626
Phone (706) 945-0810

465 N Belair Rd
Evans, GA 30809-3189
Phone (706) 854-2160

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions31

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Family Physicians of Evans Family Medicine CurrentSince Jun 1, 2001 Accepting new patients
Homestead Hospice of Augusta, LLC Family Medicine Past Accepting new patients

Locations

465 N Belair Rd
Ste 1C
Evans, GA 30809
Phone (706) 854-2160

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10037502
  • Direct secure messaging: frederickmerrill@fpe.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Empyrean Hospice of Georgia, LLCAugusta, GA, CCN 851586 Hospice Contracted Managing Employee Jan 6, 2026

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1740299650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 N BELAIR RD",
            "address_2": "SUITE 1C",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093188",
            "telephone_number": "706-854-2160",
            "fax_number": "706-854-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 N BELAIR RD",
            "address_2": "SUITE 1C",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093188",
            "telephone_number": "706-854-2160",
            "fax_number": "706-854-2930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRILL",
        "first_name": "FREDERICK",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "034664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0473327G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

Verify at the official NPI Registry.